Current status of argon laser hemostasis of bleeding ulcers

Endoscopic argon laser photocoagulation has been extensively studied in animals. Clinical pilot studies and randomized controlled trials have demonstrated that argon laser endoscopic hemostasis is both safe and efficient. Specific guidelines for successful endoscopic hemostasis have been determined. The limitations of the argon laser for emergency hemostasis are a strong absorption by blood, its expense and lack of portability, the inability to tamponade or to treat tangentially, and the vaporization potential. The Nd:YAG laser shares all these limitations except that it is less absorbed by blood. Because of these limitations, GI lasers are at present being used less for emergency hemostasis than for elective tumor ablation. Some new, non-laser, thermal devices which do not have these limitations have been developed. They are currently being evaluated in randomized trials. Perhaps because of these factors, the good results obtained with lasers for emergency hemostasis of bleeding ulcers have not been translated into clinical practice at most hospitals.